How much rates vary
Facilitymedian $1,479 · 10th to 90th $501 to $3,981Professionalmedian $112 · 10th to 90th $17 to $263
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $213.80 | Professional | None | $128.82 | $138.04 | $213.80 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $199.53 | Professional | None | $120.23 | $154.88 | $199.53 |
Christus Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $1,659.59 | Facility | None | $457.09 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $316.23 | Professional | None | $112.20 | $162.18 | $316.23 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $1,778.28 Typical High $5,248.07 | Facility | None | $144.54 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $181.97 | Professional | None | $128.82 | $138.04 | $181.97 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | None | $281.84 | $281.84 | $295.12 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $3,801.89 | Facility | None | $363.08 | $1,148.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $309.03 | Professional | None | $112.20 | $162.18 | $309.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $263.03 | Professional | None | $107.15 | $151.36 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $67.61 Typical High $91.20 | Professional | 52 · Reduced service | $64.57 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $25.70 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $67.61 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $67.61 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $25.70 | $27.54 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $97.72 | $102.33 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $15.14 |
Where Texas sits
The same service costs 5.4 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 50th of 51
$112
AK $537UT $100
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.